The evidence-based recommendations described below outline the standard follow-up procedures for cancer surveillance and are intended to assist you in providing optimal cancer follow-up care for your patient; these recommendations are not intended to be a substitute for clinical judgement.
Surveillance Activities & Timelines
The frequency of surveillance appointments depends on the type and stage of the cancer and the patient's individual situation.
As part of the minimum recommended follow-up, this may include:
- Periodic clinical exams,
- Blood tests such as CBC,
- Imaging such as X-ray, CT-scans, Ultrasound, Mammography
- Regular preventative age-appropriate health screening (i.e., Pap smear, clinical breast examinations, blood sugars)
For more information, please contact the referring oncologist or oncology treatment team.
Red Flags
Please be aware of these potential symptoms of cancer recurrence:
- Rapidly enlarging lymph nodes
- Unexplained weight loss with or without loss of appetite
- Unexplained fevers
- New persistent bone pain
- New persistent cough or dyspnea
- Drenching night sweats
- CBC abnormalities or rising LDH
- New persistent headache or new concerning neurologic deficits
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Referrals for Recurrence
Patients should be referred back to their treating oncologist. If the oncologist's contact information is not available, please search the type of cancer they have in the Alberta Referral Directory for the most up-to-date information and instructions for referral.
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Complications & Late Effects of Treatment
The table below outlines some other common general complications of cancer treatment:
| Complication |
Actions |
| Fatigue |
|
| Lymphedema |
|
| Peripheral Neuropathy |
- Peripheral neuropathy should improve over months
- Patients may present with tingling and numbness, pain or discomfort, or decreased hot/cold sensation
|
| Psychosocial Distress |
- Increasing helplessness/hopelessness, distress, anxiety or depression may be present
- Patients experiencing these symptoms should be encouraged to inform their oncology treatment team for appropriate psychosocial referral
|
| Weight Loss |
- Monitor patients who are at risk and refer to a registered dietician as necessary
|
| Fertility /Sexual Dysfunction |
- Some patients may experience sexual or fertility problems following cancer treatment
- The Oncology and Sexuality, Intimacy, and Survivorship (OASIS) program assists patients to manage physical and emotional concerns. To refer patients to the OASIS program, contact:
|
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Patient Support & General Recommendations
Your patient may have received an After Treatment book and the Newly Diagnosed book with resources to help.
Counselling & Support
If you feel your patient would benefit from social, psychological or spiritual counselling, resources are listed in the Counselling & Support for Patients, Families & Friends brochure.
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Healthy Lifestyle Recommendations
Your patient is encouraged to lead a healthy lifestyle. Visit Supportive Care & Living Well or the After Treatment book for more information.
Here are some evidence-informed recommendations about modifiable lifestyle factors for your information:
| Modifiable Lifestyle Factor |
Recommendations |
| Body Weight |
- Body mass index (BMI): 18.5-25 kg/m2
- Waist circumference: less than 80 cm for women / less than 94 cm for men
|
| Physical Activity |
- Try to be active for 2.5 hours (150 minutes) every week
- Spread out exercise throughout the day and week, such as 30 minutes 5 days a week
- Focus on moderate (brisk walking) to vigorous activity (jogging)
|
| Nutrition |
- Avoid sugary drinks and foods
- Eat a variety of vegetables, fruits, whole grains, and legumes
- Limit consumption of red meats (such as beef, pork, and lamb), and avoid processed meats
- Limit consumption of salty foods and foods processed with salt
|
| Dietary Supplements/ Bone Health |
- Vitamin D: 1000 - 2000 IU per day
- Calcium: 1000 mg per day (from all sources)
- Treatment and follow up as per Canadian Osteoporosis Guidelines
|
| Alcohol |
- Limit alcohol consumption (<1 drink/day, <3 drinks/week)
|
| Smoking |
- Practice smoking cessation. For help contact Alberta Quits 1-877-710-QUIT (7848) or visit albertaquits.ca and ahs.ca/guru for the clinical practice guideline
|
| Sun Exposure |
- Advise on avoidance of excessive or potentially harmful UV exposure
- Advocate for the use of sunscreen and sunglasses
- Advise against the use of indoor tanning beds
- Check skin regularly for suspicious lesion
|
| Immunizations |
- Annual non-live influenza vaccination unless contraindicated
- Other vaccinations as appropriate
|
| Other Cancer Screening |
- Age-appropriate screening such as breast, colorectal and other cancers
- Refer to screeningforlife.ca for more information
|
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Physician Support
The following resources provide support and information for physicians:
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Note: The information on this page was adapted from the AHS Guideline Resource Unit's Generic Cancer Transfer of Care Physician Letter. Also available is the Generic Cancer Transfer of Care Patient Letter.
